Interprofessional Education & Workforce Development: Higher Education s New Interface with Health System Transformation



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Interprofessional Education & Workforce Development: Higher Education s New Interface with Health System Transformation Barbara F. Brandt, PhD Associate Vice President for Education Academic Health Center Director, Minnesota Area Health Education Center Network Governors Health Workforce Taskforce March 1, 2012

Topics What is interprofessional education (IPE)? How is it related to workforce development? What s going on nationally? What s going on at the University of Minnesota? Implications for policy

Minnesota: Health System Transformation The Triple Aim (cost, quality & user experience) Total Cost of Care 156 Certified Health Homes 3 Pioneer Accountable Care Organizations Community Health Measures +30 CMMI Grant Proposals (January 2012)

Some Facts: Interprofessional Collaborative Practice & Teamwork Reduce adverse patient outcomes by 50% Reduce the average ICU stay by 50% Reduce the national average post-operative sepsis rate by half Decrease the clinical error rate from 30.9% to 4.4% Decrease the time required for healthcare professionals to develop expertise

Framework for Action on Interprofessional Education and Collaborative Practice, World Health Organization, 2010 Interprofessional education occurs when students from two or more professions learn about, from and with each other to enable effective collaboration and improve health outcomes. Interprofessional education is a necessary step in preparing a collaborative practice-ready health workforce that is better prepared to respond to local health needs. A collaborative practice-ready health worker is someone who has learned how to work in an interprofessional team and is competent to do so. Collaborative practice happens when multiple health workers from different professional backgrounds work together with patients, families, carers, and communities to deliver the highest quality of care. It allows health workers to engage any individual whose skills can help achieve local public health goals.

U.S. -- Current National Scene

Revisiting the Role of Health Professions Education Can our graduates who do not value interprofessional working, know little about each other, may never have communicated with each other, haven t been taught collaboration skills, and have no shared clinical experience as students be expected to practice effectively in the emerging health care system? Madeline Schmitt, PhD, RN, FAAN, University of Rochester, 2010

Four IPEC Competency Domains AACN, AAMC, AACP, ADEA, ASPH, AACOM Values & Ethics for Interprofessional Practice Roles & responsibilities Interprofessional Communication Teams and teamwork

Discussions with students disclosed the desire to see far more emphasis on the team approach to providing health care. Students assert that if future health care delivery systems require a team approach to provide the necessary services, today s health student must be exposed to the approach in his educational experience. Students recognize the impossibility of training all professionals in the same courses and program, emphasize the necessity of integrated training when practical. Report of the External Committee on Governance of University Health Sciences, University of Minnesota, February 1970

The Long and Winding Road (Hall and Weaver, 2001) National & International 1970s Birkenstock IPE 1972 IOM Report - Teams AHEC / GECs Health Professions Schools in Service to the Nation Pew Health Commission Reports Kellogg Community-Campus Partnerships Quentin Burdick grants Hartford Geriatrics InterdisciplinaryTeamTraining National Health Service Corps Association of Academic Health Centers: Group on Multi-Professional Education (GOMPE) World Health Organization Declaration, 1988 United Kingdom, Canada, Australia, New Zealand Centre for the Advancement of Interprofessional Education (CAIPE), 1987 Journal of Interprofessional Care Canadian Interprofessional Health Collaborative All Together Better Health Conferences AND Many more.... Minnesota Center for Health Interprofessional Programs - CHIP RWJF ACT II Minnesota Area Health Education Center Minnesota Area Geriatric Education Centers End-of-life Patient-Centered Teamwork Physician & Society courses Community-University Partnership for Health Walker-Methodist Transitional Care Unit Burdick geriatrics fellowship in Moose Lake Institute for Healthcare Improvement Collaborative Immunization Tour Health Careers Center multiple activities CLARION retreats and national case competition Fourteen AHEC rural interprofessional sites Hartford GITT IERC faculty development activities Tufts Institute on Systems AND many more...

Follow-up National Work: Interprofessional Partners In Action Disseminate Communications Plan Disseminate Education & Practice Models IPTBC Faculty Development Disseminate Research Metrics Disseminate

Leadership Question: Are we seeing parts of the elephant or the whole elephant?

It s scope of practice! More primary care!! It s health professions education system Team Training!! There is no problem our system is great! It s the health delivery system!

Three Phase Structure

Phase I: Foundations of Interprofessional Communication and Collaboration (FIPCC) Nearly 900 entry-level students in 76 small groups Twin Cities, UMR and UMD Introduce IPE to early-career professionals Addresses stereotypes & biases Develop new approaches and materials targeting early-career professionals Assess currently available metrics for IPE readinesse Invite new professional groups Develop new assessment tools specific for early-career professionals

Phase III IPE Site Development

Medical Education & Research Costs: MERC & IPE in the community Small grants to communities to develop IPE teaching sites focused on communityidentified health issues Working toward community health outcomes Teaching IP awareness & skills while learning clinical skills Documented impact Developing evaluation of sites

What s Next? Policy Implications Question old workforce thinking for the 21 st Century Need to think mega-systems interface for innovation Collaboration all the way to the boardroom CTSI Community-University Board RWJF: The Nexus Project Collaboration with the University of Toronto

Vermont Blueprint for Health, January 2012